In November 2017, VCSQI sent out an Opioid Prescribing Survey to its TCPI program participants. In completing and reviewing the survey responses for his six surgeons at Cardiovascular Surgeons Group (Orlando, FL), CEO Steve Dickson learned that:

There were no existing opioid prescribing standards in place, and

There is wide variation in prescribing practices amongst the surgeons.

On February 7, 2017, Ivan Berkel and Eddie Fonner met with Steve and two CSG nurses to review the survey results, discuss current opioid prescribing practices, and begin to develop opioid prescribing standards to share with the surgeons.

During a 3-hour meeting, the nurses provided an effective overview of the patient pathway from Surgery to Post-Discharge Visit. Their experience with post-surgical care and pain thresholds shed light on the following:

In surgical practice, opioid prescribing variation is normal and sometimes necessary as a result of: